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Review: rivastigmine reduces rate of cognitive decline and improves performance in mild to moderate Alzheimer’s

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Question

Question:

Is rivastigmine effective for the treatment of Alzheimer’s disease?

Outcomes:

Cognitive function (measured by psychometric tests); dependency; global impression; functional performance; behavioural disturbance; quality of life; rates of institutionalisation; effect on carer; acceptability of treatment as measured by withdrawal from trials; adverse effects; death.

Methods

Design:

Systematic review with meta-analysis.

Data sources:

The Specialised Register of the Cochrane Dementia and Cognitive Improvement Group (searched from date of inception to December 2005). The Cochrane Library, MEDLINE, PsycINFO, EMBASE, CINAHL and LILACS were searched for records added after December 2005 to March 2008; ongoing and other unpublished trials searched through Novartis, FDA, EMEA, NICE, Google and Copernic websites.

Study selection and analysis:

Randomised, double blind, placebo controlled trials of rivastigmine administered to patients with Alzheimer’s disease or probable Alzheimer’s disease (fulfilling DSM-IV or NINCDS-ADRDA) for more than 2 weeks. Exclusions: non-randomised trials; no allocation concealment. A single reviewer selected studies and assessed the quality of included trials on the basis of allocation concealment. Results from individual studies were combined and odds ratios were used to assess treatment …

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